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July-August Publisher’s Message

Trends Offering Real-Time Growth Strategies

  • Four Key Trends Impacting Chronic Care Management, Physician Practices, and Payers
  • Five Payer Strategies Ramping-up Home Care Usage
  • Six Ways to Recharge Clinical Engagement and Work/Life Balance
  • Nine Payer and State Medicaid Managed Care Investments in
    Social Determinants
  • Three Secrets for Accelerating Home Health and Hospice Growth
    and Referrals

There are so many market dynamics changing healthcare’s future. Keeping up with them can be daunting. More than ever it is important to understand the impact these changes have on your business growth and sustainability.

How Are Market Dynamics Changing?

Payers are focusing on chronic care management and social determinants. As a result, payers are expanding new care delivery in the home. Additionally, some payers are buying up physician groups and adding technology.

The primary care market is rapidly changing. Recent examples are Optum buying Landmark Health, and OneMedical buying Iora Health. Both of these physician organizations had a model that included housecalls and value-based contracts with payers. Trends are signally the importance of ramping up your managed care contracts and paying attention to the physician groups in your market. Your referral sources are expanding.

Dovetailing with these market changes is the announcements by CMS. In the care at home market, there will be an expansion of the Home Health Value-Based Purchasing Model and a new palliative care payment model. Externally, insurers such as Humana have become a Direct Contracting Entity. In primary care, value-based care is being tested in models such as CMS’s Primary Care First. The Center for Medicare and Medicaid Innovation (CMMI) is focused on moving away from fee-for-service toward more capitated payments. Many of your organizations are in these models with Medicare Advantage Plans.

You may be thinking…we’ve been hearing about value-based contracting for years. What is different about today are the lessons learned from COVID that affected both hospitals and physicians. Many physicians got stung by being in traditional fee-for-service. The market will now move much faster than it did in the past.

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